Lead Referrals Coordinator

SAC Health • San Bernardino, CA

1d • Onsite

About The Position

Under the direction of the Supervisor, Referral Coordinator, the Lead Referral Coordinator is responsible for the coordination, processing, and scheduling of specialty referrals, and prior authorizations for a variety of medical services/procedures for patients as requested by the primary care physician. As an integral member of the patient's health home, the Referral Care Coordinator Lead will collaborate with medical providers, nursing staff, and other patient care support staff to ensure patients receive specialty services timely and efficiently in alignment with department of health care guidelines. The Lead Referral Coordinator will also be responsible for providing training on standard work procedures. Additionally, this role acts as a liaison with staff, departments, clinics, and patients. Performs other duties as assigned.
Schedule: 4 days 10 hours a day, Tue - Fri 7:00 am - 5:30 pm | Location: Brier Clinic, San Bernardino, CA

Requirements

• Education: High School Diploma or equivalent required. Associate's degree preferred.
• Licensure/Certification: As a requirement of this position, you must receive EPIC certification for the module you have been hired into.
• Experience: Minimum of one (1) year experience in medical referrals, or other related medical patient support functions in an ambulatory care setting preferred. Intermediate proficiency in data analysis. Proficient in Microsoft Office and electronic medical record system (EMR). Knowledge of referral operations (in order to interpret and validate data findings) preferred.
• Essential Technical/Motor Skills: Must have proficient computer skills including data entry (35wpm). Computer proficiency: Excel, Word, Outlook, EPIC, PDF, etc.
• Interpersonal Skills: Ability to work effectively in a team environment is essential. Must have professional telephone etiquette with a pleasant and courteous voice. Strong public relations skills and fluency in English and Spanish are required. Ability to translate medical information is preferred. Must maintain a professional attitude in difficult situations, communicate effectively, and work well in a team. Strong organizational skills, attention to detail, and excellent communication and interpersonal abilities are essential.
• Essential Mental Abilities: Requires strong critical thinking and decision-making skills. Flexibility and the ability to handle various tasks and changing priorities are essential. The candidate must be well-organized, able to manage multiple tasks efficiently, and handle multiple phone lines simultaneously.
• Work Eligibility: Must be legally authorized to work in the United States on a full-time basis. Must not now or in the future require sponsorship for employment visas.

Nice To Haves

• Associate's degree preferred.
• Minimum of one (1) year experience in medical referrals, or other related medical patient support functions in an ambulatory care setting preferred.
• Knowledge of referral operations (in order to interpret and validate data findings) preferred.
• Ability to translate medical information is preferred.

Responsibilities

• Assist Referral Coordinators with achieving team and individual goals, guide team members, ensure tasks are completed, and provide technical expertise.
• Assist with referrals and resolve patient issues.
• Ensure referrals and authorizations are processed appropriately and on time.
• Maintain knowledge of insurance policies, referral, and authorization procedures.
• Work with insurance companies / managed care groups to ensure pre-visit information is sent to patients as needed.
• Maintain an accurate and up-to-date tracking system for referrals and authorizations.
• Utilize exceptional customer service skills in performing duties and assists with problematic authorization processes.
• Contact patients as needed to update demographics and informs them or /guarantors of their financial responsibility for scheduled services.
• Review referral orders for accuracy of codes and supporting documentation.
• Receive and process specialty notes to primary care physicians to facilitate ongoing authorizations for continued care.
• Recommend improvements to department processes as appropriate.
• Understand the referral process at the highest level and assist referral staff to ensure compliance with program guidelines.
• Assist referral staff to ensure accurate and timely review and entry of authorizations from referring entity.
• Assist with difficult patient situations and processes.
• In coordination with the Referrals Supervisor, plan, organize, direct, coordinate and supervise the operations of the referrals department.
• Monitor and report productivity statistics data to the supervisor on a weekly basis; may assist in monitoring other coordinators' statistics.
• Assist the supervisor with special projects as requested.
• Serve as a liaison and authorization resource to clinic staff, outside medical groups and patients.
• Perform general clerical duties, including typing, filing, answering the telephone, monitoring incoming faxes/mail, and assisting patients/providers at the service window or patient exam room.
• Develop and maintain professional working relationships with outside providers, vendors and insurance groups involved in the referral process.
• Work cohesively with all other SAC Health departments.
• Demonstrate a caring and compassionate commitment to patients and their unique circumstances.
• Lead by example and ensure all employees promote the mission by displaying behavior consistent with SAC Core Values.
• Demonstrate flexibility, adaptability; and the ability to work under pressure to meet deadlines.
• Work as a team and contribute to development of an effective work environment.
• Transforms delivery of clinical care - Promote services and program strategies that provide an exceptional patient - centered experience by developing a seamless care delivery system and innovative care models to improve quality outcomes, reduce unnecessary clinical variation, and improve coordination across the continuum.
• Perform other duties as assigned by department leadership.

Benefits

• Full Benefits Package!
• Industry Leading PTO Accrual (accrued per pay period)
• Sick Leave
• Paid Holidays
• Paid Jury Duty, Bereavement
• SAC Health Covers approximately 85% of Team Member health premium costs (may vary w/benefit plan selection)
• Retirement - up to 8% employer contribution
• Continuing Education and Learning Benefits
• Annual Mission Trip and much more!

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED